In this paper, I critique two conceptions of mechanisms, namely those put forth by Stuart Glennan (Erkenntnis 44:49–71, 1996; Philosophy of Science 69:S342–S353, 2002) and Machamer et al. (Philosophy of Science 67:1–25, 2000). Glennan’s conception, I argue, cannot account for mechanisms involving negative causation because of its interactionist posture. MDC’s view encounters the same problem due to its reificatory conception of activities—this conception, I argue, entails an onerous commitment to ontological dualism. In the place of Glennan and MDC, I propose (...) a “modified conception” of mechanisms, which (a) obviates the problem of negative causation by reinterpreting MDC’s activities according to a “descriptivist” account, and (b) avoids MDC’s problem by postulating a monistic ontology of entities. Thus, by solving these problems, my modified conception offers a cogent, more adequate alternative to Glennan’s and MDC’s conceptions of mechanisms. (shrink)

In the contemporary biomedical literature, every disease is considered genetic. This extension of the concept of genetic disease is usually interpreted either in a trivial or genocentrist sense, but it is never taken seriously as the expression of a genetic theory of disease. However, a group of French researchers defend the idea of a genetic theory of infectious diseases. By identifying four common genetic mechanisms (Mendelian predisposition to multiple infections, Mendelian predisposition to one infection, and major gene and polygenic predispositions), (...) they attempt to unify infectious diseases from a genetic point of view. In this article, I analyze this explicit example of a genetic theory, which relies on mechanisms and is applied only to a specific category of diseases, what we call “a regional genetic theory.” I have three aims: to prove that a genetic theory of disease can be devoid of genocentrism, to consider the possibility of a genetic theory applied to every disease, and to introduce two hypotheses about the form that such a genetic theory could take by distinguishing between a genetic theory of diseases and a genetic theory of Disease. Finally, I suggest that network medicine could be an interesting framework for a genetic theory of Disease. (shrink)

Medical explanations have often been thought on the model of biological ones and are frequently defined as mechanistic explanations of a biological dysfunction. In this paper, I argue that topological explanations, which have been described in ecology or in cognitive sciences, can also be found in medicine and I discuss the relationships between mechanistic and topological explanations in medicine, through the example of network medicine and medical genetics. Network medicine is a recent discipline that relies on the analysis of various (...) disease networks in order to find organizing principles in disease explanation. My aim is to show how topological explanations in network medicine can help solving the conceptual issues that pure mechanistic explanations of the genetics of disease are currently facing, namely the crisis of the concept of genetic disease, the progressive geneticization of diseases and the dissolution of the distinction between monogenic and polygenic diseases. However, I will also argue that topological explanations should not be considered as independent and radically different from mechanistic explanations for at least two reasons. First, in network medicine, topological explanations depend on and use mechanistic information. Second, they leave out some missing gaps in disease explanation that require, in turn, the development of new mechanistic explanations. Finally, I will insist on the specific contribution of topological explanations in medicine: they push us to develop an explanation of disease in general, instead of focusing on single explanations of individual diseases. This last point may have major consequences for biomedical research. (shrink)

This paper aims to clarify the nature of understanding in medicine. The first part describes in more detail what it means to understand something and links a type of understanding (i.e., objectual understanding) to explanations. The second part proceeds to investigate what objectual understanding of a disease (i.e., biomedical understanding) requires by considering the case of scurvy from the history of medi- cine. The main hypothesis is that grasping a mechanistic explanation of a condi- tion is necessary for a biomedical (...) understanding of that condition. The third part of the paper argues that biomedical understanding is necessary, but not sufficient for understanding in a clinical context (i.e., clinical understanding). The hypothe- sis is that clinical understanding combines biomedical understanding of a disease or pathological condition with understanding illness, which involves some degree of personal understanding of the patient. It is argued that, in many cases, clinical understanding necessitates adopting a particular second-personal stance and using cognitive resources in addition to those involved in biomedical understanding. (shrink)

This chapter provides a brief overview of the history of behavioral neurology, dividing it roughly into six eras. In the ancient and classical eras, emphasis is placed on two transitions: firstly, from descriptions of head trauma and attempted neurosurgical treatments to the exploratory dissections during the Hellenistic period and the replacement of cardiocentrism; and secondly, to the more systematic investigations of Galenus and the rise of pneumatic ventricular theory. In the medieval through post-Renaissance eras, the scholastic consolidation of knowledge and (...) the role of compendia are emphasized, along with the use of new methods from within a mechanistic framework. With the discovery of electrical conductance and the rise of experimentalism, we frame the modern era as period of intense debate over localization, decomposition, and other mechanistic principles, and marked by rapid discovery about the brain. The chapter ends with a discussion of the contemporary era, focusing on the establishment of behavioral neurology research on aphasia, apraxia, and neuropsychiatric conditions. (shrink)

Debates about evolution and creation inevitably raise philosophical issues about the nature of scientific knowledge. What is a theory? What is an explanation? How is science different from non- science? How should theories be evaluated? Does science achieve truth? The aim of this chapter is to give a concise and accessible introduction to the philosophy of science, focusing on questions relevant to understanding evolution by natural selection, creation, and intelligent design. For the questions just listed, I state what I think (...) is the best available answer and show how it applies to debates about evolution and creationism. I also indicate alternative answers that are preferred by other philosophers. I hope that the result will be useful for science educators and anyone else involved in controversies about evolution and creation. (shrink)

Biology is the study of life, psychology is the study of mind, and medicine is the investigation of the causes and treatments of disease. This chapter describes how the central concepts of life, mind, and disease have undergone fundamental changes in the past 150 years or so. There has been a progression from theological, to qualitative, to mechanistic explanations of the nature of life, mind and disease. This progression has involved both theoretical change, as new theories with greater explanatory power (...) replaced older ones, and emotional change as the new theories brought reorientation of attitudes toward the nature of life, mind, and disease. After a brief comparison of theological, qualitative, and mechanistic explanations, I will describe how shifts from one kind of explanation to another have carried with them dramatic kinds of conceptual change in the key concepts in the life sciences. Three generalizations follow about the nature of conceptual change in the history of science: there has been a shift from conceptualizations in terms of simple properties to ones in terms of complex relations; conceptual change is theory change; and conceptual change is often emotional as well as cognitive. The contention that historical development proceeds in three stages originated with the nineteenth-century French philosophers, Auguste Comte, who claimed that November 9, 2006 human intellectual development progresses from a theological to a “metaphysical” stage to a “positive” (scientific) stage (Comte, 1988). The stages I have in mind are different from Comte’s, so let me say what they involve. By the theological stage I mean systems of thought in which the primary explanatory entities are supernatural ones beyond the reach of science, such as gods, devils, angels, spirits, and souls. For example, the concept of fire was initially theological, as in the Greek myth of Prometheus receiving fire from the gods.. (shrink)

Here are some of the most important discoveries in the history of medicine: blood circulation (1620s), vaccination, (1790s), anesthesia (1840s), germ theory (1860s), X- rays (1895), vitamins (early 1900s), antibiotics (1920s-1930s), insulin (1920s), and oncogenes (1970s). This list is highly varied, as it includes basic medical knowledge such has Harvey’s account of how the heart pumps blood, hypotheses about the causes of disease such as the germ theory, ideas about the treatments of diseases such as antibiotics, and medical instruments such (...) as X-ray machines. The philosophy of medicine should be able to contribute to understanding of the nature of discoveries such as these. The great originators of the field of philosophy of science were all concerned with the nature of scientific discovery, including Francis Bacon (1960), William Whewell (1967), John Stuart Mill (1974), and Charles Peirce (1931-1958). The rise of logical positivism in the 1930s pushed discovery off the philosophical agenda, but the topic was revived through the work of philosophers such as Norwood Russell Hanson (1958), Thomas Nickles (1980), Lindley Darden (1991, 2006), and Nancy Nersessian (1984). Scientific discovery has also become an object of investigations for researchers in the fields of cognitive psychology and artificial intelligence, as seen in the work of Herbert Simon, Pat Langley, and others (Langley et al., 1987; Klahr, 2000). Today, scientific September 14, 2009 discovery is an interdisciplinary topic at the intersection of the philosophy, history, and psychology of science. The aim of this chapter is to identify patterns of discovery that illuminate some of the most important developments in the history of medicine. I have used a variety of sources to identify forty great medical discoveries (Adler, 2004; Friedman and Friedland, 1998; Science Channel, 2006; Strauss and Strauss, 2006).. (shrink)